Pre-Registration Form

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Are you currently pregnant?(Required)
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Are you or any of your children currently enrolled in any Head Start/Early Head Start Program? If so, where?(Required)
Do you have a child that was previously enrolled in any Head Start/Early Head Start Program?” If so, where?(Required)
Do you receive any income/cash payments from MDHHS (excluding food stamps/bridge card) or for SSI?(Required)
If you had a choice, which Development Centers program option would best service your family’s needs?